| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $582.00 | $629.00 | $2,530.00 | |
Cigna
| Facility | AS | $152.11 | $152.11 | $152.11 |
Kaiser Permanente
| Professional | $1,204.18 | $1,644.65 | $2,288.21 | |
United
| Facility | $1,028.00 | $1,347.00 | $3,219.00 |